Please fill out the form below and we will be in touch with you as soon as we review it: Please enable JavaScript in your browser to complete this form.Name *FirstLastEmail *Cell Phone *Date of Birth *MM123456789101112DD12345678910111213141516171819202122232425262728293031YYYY20262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920 skin preparation *I understand I should prepare my skin for my session prior to my arrival. Skin should be free of deodorant, sweat, lotions, and it should be exfoliated (removal of dead, dry skin cells) and shaved. Remove all make-up and not wear jewelry of any kind. If I attend an airbrush tanning session without proper preparation, Bronze Me Brazilian cannot guarantee lasting or satisfactory results.DHA *I understand that DHA is clear and can take up to 24 hours fully develop. After spraying, I should not bathe for 24 hours. Exposure to excessive moisture before this time period may affect my results. When my session is over the solution will give me an immediate bronzing effect. When I shower, the bronzer will come off and reveal my true tan color.Moisture *I understand that DHA is clear and can take up to 24 hours fully develop. During this time it is important to refrain from moisture build-up on the skin. (i.e. swimming, rain, showering, swearing, massage & pedicures)Barriers *I understand not to use these products such as moisturizers, shaving gels or waxes, which contain petrolatum, petroleum jelly, mineral oil or paraben less than 24 hours PRIOR to tanning session as the oils contained in these products may cause a barrier on the skin and will neutralize the DHA bronzing reaction.Timing *I understand that a spray tan only last as long as it takes to my skin to naturally exfoliate 7 to 10 days, depending on skin type and after care.Are you pregnant or lactating?YesNoAre you diabetic or had or have any history of skin cancer, glaucoma, cataracts, retinal detachment or retinopathy, Lupus or any skin inflammation or respiratory problems?YesNoPregnancy *I understand that if in case I am pregnant/lactating, diabetic or had or have any history of skin cancer, glaucoma, cataracts, retinal detachment or retinopathy, Lupus or any skin inflammation or respiratory problems, I MUST HAVE PERMISSION IN WRITING BY A DOCTOR prior to any spray tan session.Allergies *I understand that I MUST let Bronze Me Brazilian know in case I'm having any advance allergies, especially of using Accutane as I understand that acne products dry the skin and DHA is very sensitive to dryness.Are you under 16 years old?NoYesAge *I understand if I am under the age of 16, I must have a signature of my parents/guardian prior to any spray tan session.Laser Treatment *I understand that if I am planning a laser treatment in the following weeks, I need to consult with my laser technician before having a spray tan.Freckles *I understand that freckles may darken with the spray tan service.Sunburn *I understand that I MUST inform Bronze Me Brazilian if I had sunburn in the last three weeks; otherwise, If I am tanning, I will have some peeling.Vitiligo *I understand that if I have vitiligo, we can’t match the color.Psoriasis *I understand that if I have psoriasis or eczema, I MUST wait for it to clear up; otherwise, the spray tan looks uneven.By checking all the boxes above, I agree to have these services and I accept all responsibility for such thereby releasing the BMB and the service provider (Technical Professional) from liability. *I agreeSubmit
